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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Assessing health-related quality of life in persons infected with human immunodeficiency virus (HIV) is extremely important, but most available scales are too long, contain items that are not relevant for such persons, or do not assess important signs and symptoms of HIV infection. This study presents a new set of scales for assessing the symptoms and functioning of persons infected with HIV and reports data on their reliability and validity collected in face-to-face interviews with 189 patients receiving primary care. This study also assesses the associations among systems, functional impairment, and global health assessments. The scales are easy to administer, are reliable, and serve as valid measures of quality of life. Fatigue, functional status, and average severity of all symptoms were the best predictors of overall perceived health status. Psychological well-being and perceived health status were the best predictors of overall perceived health status. Psychological well-being and perceived health status were the strongest correlates of life satisfaction. When assessing the health-related quality of life of persons infected with HIV, this study recommends utilizing a comprehensive set of measures that allows one to examine both discrete symptoms and the more diffuse impact of illness on functioning, mental health, and quality of life.
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PMID:Health-related quality of life in persons with acquired immune deficiency syndrome. 832 72

Twenty-five HIV-infected patients underwent hyperbaric oxygen therapy to determine the treatment's effectiveness in relieving the debilitating fatigue associated with HIV/AIDS and its effect on immunologic function. Patients were treated with 100% oxygen at two atmospheres of absolute pressure three times per week for two months, then two times per week on an ongoing basis. Laboratory markers were assessed monthly. All patients experienced relief of debilitating fatigue within one month of hyperbaric oxygen therapy. It was concluded that hyperbaric oxygen therapy is an effective adjunctive treatment in the medical management of HIV/AIDS. Laboratory markers, clinical significance, nursing implications, and cost-effectiveness of hyperbaric oxygen therapy are discussed.
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PMID:Hyperbaric oxygen therapy for the treatment of debilitating fatigue associated with HIV/AIDS. 840 Jan 58

We investigated the long-term health effects of HIV-1 infection in homosexual men not close to developing AIDS by comparing 916 HIV-1-seropositive (SP) men at least 1.67-3.67 years prior to a clinical AIDS diagnosis to 2,161 HIV-1-seronegative (SN) controls. The SP group reported a higher total of 12 distinct symptoms (fatigue, shortness of breath, night sweats, rash, cough, diarrhea, headache, thrush, skin discoloration, fever, weight loss, and sore throat/mouth) than did the SN group (p < 0.0001), corresponding to at least 5.6 more days/year of such symptoms. The SP group had lower body mass index (p < 0.0001) and lower hemoglobin (p < 0.0001). The SP group was more depressed, as measured by CES-D score (p = 0.047), before knowledge of one's serostatus was likely, and became even further depressed (p = 0.038 for increase in depression) after the HIV-1 serostatus test was accessible to high-risk groups. These associations remained unchanged in multivariate models, incorporating other covariates.
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PMID:Signs and symptoms of "asymptomatic" HIV-1 infection in homosexual men. Multicenter AIDS Cohort Study. 826 59

A Haitian woman with the human immunodeficiency virus (HIV) presented with dyspnea, cough, fatigue and lower abdominal pain of recent onset. Clinical, radiologic and hemodynamic investigations demonstrated pulmonary hypertension. The patient died a few days later. The pathological findings were compatible with primary pulmonary hypertension. This case is similar to others that have been reported and indicates a possible link between HIV infection and rapidly progressive primary pulmonary hypertension.
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PMID:Primary pulmonary hypertension associated with HIV infection. 842 54

This retrospective study outlines interventions taken as a result of rehabilitation medicine consultation in persons hospitalized with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). The medical records of 30 persons with HIV infection consecutively referred for rehabilitation medicine consultation over a one-year period were reviewed. The sample was composed primarily of white, homosexual males with a mean age of 38.5 (SD, 8.5) years and a mean length of AIDS diagnosis of 14.6 (SD, 14.1) months. Rehabilitation medicine evaluation resulted in additional diagnoses in four cases (13.3%), prescriptions for new medications in 8 (26.7%), physical modalities/devices in 9 (30.0%) and referrals to occupational, physical and speech therapies in 26 (86.7%), 24 (80.0%) and 3 (10.0%) patients, respectively. Interventions were often directed toward deconditioning, painful peripheral neuropathy and fatigue. Mean survival after rehabilitation consultation was approximately 23 weeks. No intervention was novel or unusual suggesting that current knowledge is sufficient to manage much of the disability associated with HIV infection. This study concludes that rehabilitation medicine can contribute to the management of persons hospitalized with AIDS. Further research should address efficacy of intervention, fatigue as a source of disability and the value of early rehabilitation intervention.
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PMID:Rehabilitation medicine consultation in persons hospitalized with AIDS. An analysis of thirty cases. 847 49

The number of AIDS patients over age 60 has risen steadily in the past decade. The number of transfusion-acquired AIDS cases probably has peaked--or will soon peak. Homosexual (or bisexual) behavior remains the predominant risk factor for AIDS until the seventh decade. Disease progression appears to be more rapid in the elderly, although the observed shorter survival time may result from a delay in diagnosis. Symptoms of HIV infection are often nonspecific, such as fatigue, anorexia, weight loss, and decreased physical and cognitive function. The five most common opportunistic infections in older HIV-infected patients are Pneumocystis carinii pneumonia, tuberculosis, Mycobacterium avium complex, herpes zoster, and cytomegalovirus. A number of features of HIV-related dementia may help to distinguish it from Alzheimer's disease.
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PMID:HIV infection in older patients: when to suspect the unexpected. 850 Jul 75

In order to determine the prevalence of cortisol deficiency in advanced HIV disease and to examine whether it may be predicted by clinical features or biochemical abnormalities, we conducted a prospective study which assessed responses to a rapid ACTH stimulation test (short-duration synthetic corticotrophin test, synacthen test) in HIV-positive patients with a CD4 count of < or = 50 x 10(6)/l. Subjective fatigue, postural drop in blood pressure, electrolyte changes, presence of concurrent opportunist infection and drug treatment were recorded. Cortisol responses were defined as 'normal' (a post stimulation cortisol level > or = 450 nmol/l), 'abnormal' (post stimulation cortisol level < 350 nmol/l) or 'impaired' (an intermediate response). Of 49 patients tested (42 male, seven female), a suboptimal response (abnormal or impaired) was found in 14 (29%) and frank insufficiency in eight (16%). Cortisol deficiency was not predicted by postural drop in blood pressure, biochemistry or symptoms of fatigue. Patients with an impaired/abnormal test were not more likely to have cytomegalovirus or mycobacterial disease but were more likely to be taking megestrol acetate (P = 0.05, Fisher's exact test). Two of three patients with initially normal tests developed impaired/abnormal cortisol responses on re-testing 6-9 months later. Cortisol deficiency is common in late stage HIV disease, but symptoms of fatigue and postural hypotension, as well as biochemical findings, are poor predictors of cortisol deficiency. We found good subjective response to therapy. Routine screening by a rapid ACTH stimulation test is recommended in HIV-positive patients with CD4 count < or = 50 x 10(6)/l. Re-testing at regular intervals may be necessary. The interaction between megestrol acetate, cortisol metabolism and synacthen testing requires further investigation.
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PMID:Prevalence of cortisol deficiency in late HIV disease. 852 25

Ten HIV-positive patients were given thyroid hormone in pharmacological doses. Two patients that had CD4 counts of 200 or higher responded well with gain in weight, energy, endurance and well-being within 6 months. During the same period, their CD4 counts rose to within normal limits and remained there. One patient has been well for 3 years and the other for 1 year. Six other patients with counts below 200 have had variable clinical improvements during the first 6 months but no change in CD4 counts. Thyroid therapy in pharmacological doses helps most patients with symptoms of fatigue or depression. At the same time, it may retard or prevent the progression from HIV infection to AIDS.
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PMID:Thyroid therapy in HIV-infected patients. 853 32

To assess the health values of patients infected with human immunodeficiency virus (HIV) and examine the relationships between their health values and health status at two points in time, the authors sought to determine whether patients' physical and mental health statuses were good predictors of how they valued their current state of health. One hundred thirty-nine patients with various stages of HIV infection were interviewed in a prospective cohort study based in a primary care practice of a community-based teaching hospital. Patients were interviewed twice at 6-month intervals using three health value measures--the time trade off, rating scale, and Quality of Well-being Scale--and three health status measures: the 18-item Mental Health Inventory, the Dyspnea-Fatigue Index, and the Medical Outcomes Study SF-36 Health Survey. The health status of HIV-infected patients was compromised and, with the exception of mental health, generally was worse among patients with more advanced HIV-infection. Rating scale and Quality of Well-being Scale scores were related inversely to disease stage, but time-trade off scores generally were higher regardless of disease stage. Health value measures showed moderate relationships with measures of physical functioning (r = 0.34-0.68) but only a fair relationship with mental health (r = 0.00-0.48). The health status of HIV-infected patients who remained asymptomatic or remained symptomatic but without developing acquired immunodeficiency syndrome (AIDS) changed little over 6 months, whereas the health status of patients with AIDS and of patients manifesting progression of HIV-infection deteriorated over time. In contrast, health values, particularly time-tradeoff scores, remained stable even in the face of changes in health status and disease progression. With the exception of mental health, the impact of HIV infection on health status tends to parallel the clinical stage of disease. Health values of HIV-infected patients, however, generally are high and correlate better with physical functioning than with mental health.
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PMID:Health values of patients infected with human immunodeficiency virus. Relationship to mental health and physical functioning. 855 11

Alcohol consumption as a cofactor in the progression of HIV infection was examined in 1,446 homosexual and bisexual HIV + men enrolled in the Multicenter AIDS Cohort Study who had a minimum of three visits. Two measures of drinking were employed: initial level, and pattern during the study period. Outcome measures included AIDS-related symptoms and AIDS diagnosis. Level of drinking at entry to the study was not significantly associated with either AIDS-related symptoms at final visit or with AIDS diagnosis. However, men who decreased drinking were more likely to report thrush, fatigue, weight loss, and diarrhea at their final visit. Most likely, these men decreased drinking as a result of failing health, not because their drinking pattern influenced symptom onset. These data support earlier reports that found no relationship between alcohol consumption and progression to AIDS.
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PMID:Alcohol consumption as a cofactor in the progression of HIV infection and AIDS. 859 Jun 17


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